飞秒激光辅助LASIK术后早期角膜生物力学各指标的变化

Short-term changes of corneal biomechanical properties after FS- LASIK

摘要:

目的：探讨准分子激光原位角膜磨镶术(LASIK)使用Femto LDV飞秒激光制瓣近视患者的角膜生物力学各指标的变化。

方法：选取93例186眼近视患者均行飞秒激光辅助LASIK术。分别于术前； 术后3，6mo应用眼反应分析仪(ocular response analyzer，ORA)检测角膜补偿眼压(corneal compensated intraocular pressure，Iopcc)、模拟Goldmann眼压(Goldmann correlated IOP value，Iopg)、角膜阻力因子(corneal resistance factor，CRF)、角膜滞后量(corneal hysteresis，CH)。超声角膜厚度测量。比较术后3mo与术前，术后6mo与术后3mo测量值的差异。

结果：术后3mo中央角膜平均厚度为447.61±39.57μm与术前539.88±29.72μm比较，差异有显著统计学意义(t=-47.223，P=0.000)； 术后6mo 448.78±39.19μm较术后3mo厚度差异有统计学意义(t=2.15，P=0.033)。术后3mo Iopcc，Iopg分别为13.75±2.13，9.54±2.35mmHg较术前16.29±2.88，15.09±3.29mmHg显著降低(t=-13.604，-23.594； P=0.000，0.000)。Iopcc，Iopg分别较术前降低2.55±2.25，5.55±3.21mmHg。术后6mo 13.61±1.96，9.32±2.07mmHg与术后3mo比较差异无统计学意义(t=-0.977，1.447，P=0.33，0.15)。CRF，CH术后3mo测量值6.36±1.45，7.71±1.30mmHg较术前9.84±1.99，9.77±1.56mmHg显著降低(t=-24.116，

-19.171； P=0.000，0.000)。CRF，CH分别较术前降低3.49±1.97，2.06±1.47mmHg。术后6mo 6.24±1.38，7.67±1.25mmHg与术后3mo比较差异无统计学意义(t=1.456，0.636，P=0.147，0.525)。

结论：飞秒激光辅助LASIK术对角膜生物力学有显著影响，术后角膜生物力学各指标较术前显著降低。术后3mo内生物力学各指标基本稳定。

Abstract:

AIM:To investigate the changes of corneal biomechanics after Femto LDV laser flapping in laser in situ keratomileusis(LASIK).

METHODS: Preoperatively, 3 months, 6 months after LASIK, 93 myopia patients(186 eyes)in flapping procedure by Femto LDV laser were examined by Ocular response analyzer(ORA). The central corneal thickness(CCT)was also measured by ultrasonic pachymetry. Parameters were compared between postoperative(3 months)and preoperative, postoperative(6 months). Comparisons included the corneal thickness and corneal compensated intraocular pressure(Iopcc), Goldmann correlated IOP value(Iopg), corneal resistance factor(CRF), corneal hysteresis(CH).

RESULTS:The CCT(447.61±39.57μm)were significantly changed comparing with preoperative(539.88±29.72μm)(t=-47.223; P=0.000). The CCT of 6 months postoperative(448.78±39.19μm)was slightly thicker than that of 3 months'(t=2.15,P=0.033). Iopcc, Iopg of 3 months after LASIK(13.75±2.13, 9.54±2.35)mmHg were significantly changed comparing with preoperative(16.29±2.88, 15.09±3.29 )mmHg(t=-13.604, -23.594; P=0.000, 0.000). The difference was(2.55±2.25, 5.55±3.21)mmHg. There were no significant changes between Iopcc, Iopg of 6 months(13.61±1.96,9.32±2.07)mmHg and that of 3 months after LASIK. CRF and CH of 3 months after LASIK(6.36±1.45,7.71±1.30)mmHg were significantly changed comparing with preoperative's(9.84±1.99,9.77±1.56)mmHg(t=-24.116, -19.171; P=0.000, 0.000). The difference was(3.49±1.97, 2.06±1.47)mmHg. There were no statistical differences between 6 months(6.24±1.38, 7.67±1.25)mmHg and 3 months(t=1.456, 0.636; P=0.147, 0.525).

CONCLUSION: The corneal biomechanical properties after FS- LASIK are lower than that of preoperative. Corneal biomechanics sustains steadily about 3 months after LASIK.